Medically reviewed by Kevin Wandler, MD, Chief Medical Advisor
Xylazine, often called “tranq,” is a sedative meant for animals. It has been found mixed into the illicit drug supply, most often alongside fentanyl, and many people who are exposed to it have no idea it is there. Because it acts differently from opioids, it can complicate overdose response and cause serious health problems of its own.
This article explains what xylazine is, why it is showing up in street drugs, the risks it creates and what you can do to protect yourself or someone you love. It also covers how treatment can help people who have been using drugs that may contain xylazine.
What Is Xylazine?
Xylazine is a veterinary medication used to sedate large animals such as horses and cattle. It is not approved for use in people. It is not an opioid, but it causes deep sedation, slowed breathing, slowed heart rate and low blood pressure.
The Drug Enforcement Administration has reported finding xylazine mixed with fentanyl in drug seizures across the country, and federal officials have named fentanyl combined with xylazine an emerging drug threat. It may also be found in heroin, counterfeit pills and other drugs.
Why Xylazine Is Being Added to Drugs
Xylazine may be added to fentanyl to extend or change the effects of the drug, or simply because it is inexpensive. Whatever the reason, the people using these drugs usually do not know how much xylazine, if any, is in what they are taking. Street drugs are not labeled, and their contents can change from batch to batch.
Health Risks of Xylazine
Heavy sedation and overdose
When combined with fentanyl or other opioids, xylazine can deepen sedation and further slow breathing. People may be unresponsive for longer periods, which increases the risk of choking, injury and exposure to the elements.
Serious wounds
Repeated xylazine exposure has been linked to severe skin wounds, including open sores that can become infected. These wounds can appear on parts of the body away from where drugs were injected, and they can also affect people who smoke or snort drugs. Wounds that look dark, spread, smell bad or come with fever need medical care right away.
Other effects
Xylazine can cause low blood pressure, slowed heart rate, blurred vision and disorientation. People who use it regularly may also develop dependence.
How Xylazine Affects Overdose Response
Naloxone reverses opioid overdoses. Because xylazine is not an opioid, naloxone does not reverse its effects. However, xylazine is usually found with fentanyl, so naloxone should still be given in any suspected overdose. It may restore breathing even if the person remains sedated.
If you think someone is overdosing:
- Call 911.
- Give naloxone if it is on hand, using it as the package directs.
- Support their breathing. If you are trained in rescue breathing, provide it.
- If they are breathing, place them on their side so they do not choke.
- Stay with them until help arrives.
A person who is breathing but still very sedated after naloxone still needs emergency medical care. Our guide to drug overdose symptoms describes other warning signs to watch for.
Protecting Yourself and Others
No approach removes all risk, but these steps can make a real difference for people who use drugs that may contain xylazine:
- Carry naloxone and make sure the people around you know where it is.
- Avoid using alone, so someone can call for help and provide care if you become unresponsive.
- Avoid mixing with alcohol, benzodiazepines or other sedatives, which deepen sedation.
- Check your skin regularly and get any sore that is not healing looked at by a medical provider.
- Consider treatment, which offers the most lasting protection from the risks of an unpredictable drug supply.
Withdrawal When Xylazine Is Involved
People who have been using fentanyl that contains xylazine may experience withdrawal from both substances. Some report that withdrawal feels different or more intense than opioid withdrawal alone, with symptoms such as severe anxiety, irritability and restlessness. Research on xylazine withdrawal is still developing, which is one more reason to seek medical support instead of stopping alone.
If you also use alcohol or benzodiazepines, share that with your care team. Withdrawal from alcohol and benzodiazepines can be life-threatening and should not be attempted abruptly without medical guidance.
Treatment and Recovery
People who have been exposed to xylazine may need care on several fronts: withdrawal, the opioid use disorder that is usually present and, for some, wounds that need attention from a medical provider. Be sure to mention any skin wounds during your first conversation with a treatment program so they can be factored into planning. At Promises Dallas-Fort Worth, our fentanyl detox provides medically supervised withdrawal management in Lewisville, with medication-assisted treatment used during detox when clinically appropriate.
After detox, our fentanyl addiction treatment helps people build a foundation for recovery through therapy, medical care and aftercare planning. For many people with opioid use disorder, ongoing medication-assisted treatment lowers the risk of returning to use and of overdose.
Frequently Asked Questions
How do I know if my drugs contain xylazine?
You usually cannot tell by looking, smelling or tasting. Assume that any drug from an illicit source could contain xylazine, fentanyl or other substances.
Should I still use naloxone if xylazine might be involved?
Yes. Xylazine is usually mixed with opioids, and naloxone can reverse the opioid part of an overdose. Always call 911 as well.
Can xylazine wounds heal?
Many wounds improve with proper medical care, especially when treated early. Delaying care can lead to serious infections.
Reach Out for Help Today
If you or someone you love is using drugs that may contain xylazine, help is available now. Our admissions team is available 24/7, and same-day admission is often possible when a bed is available. For a mental health crisis or thoughts of suicide, call or text 988.
We offer free, confidential insurance verification. See our insurance options, call (469) 546-9303, or send a message to our team.